Healthcare Provider Details
I. General information
NPI: 1003251265
Provider Name (Legal Business Name): BEL AIR CONTINUING CARE CENTER LTD CO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2013
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4105 TERAVISTA CLUB DR
ROUND ROCK TX
78665-1525
US
IV. Provider business mailing address
2537 GOLDEN BEAR DR
CARROLLTON TX
75006-2377
US
V. Phone/Fax
- Phone: 214-954-4114
- Fax: 214-871-3057
- Phone: 214-954-4114
- Fax: 214-871-3057
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBIN
F
UNDERHILL
Title or Position: CEO
Credential:
Phone: 214-954-4114